Treatment at Mayo Clinic

By Mayo Clinic Staff

If your doctor finds your unborn baby has a type of spina bifida, myelomeningocele, your doctor may suggest open fetal surgery to treat the condition.

Research has shown open fetal surgery to repair spina bifida had better outcomes than did surgery performed after birth. Open fetal surgery also may reduce complications of spina bifida. However, the surgery has several potential risks to you and your unborn baby.

Before the procedure

A team of doctors in maternal and fetal medicine, pediatric neurosurgery, and other areas evaluates you and your unborn baby with spina bifida to determine whether surgery is an option. Doctors will perform tests, such as ultrasounds and magnetic resonance imaging, to evaluate your unborn baby and determine the exact location of the opening.

Your doctor will carefully and individually explain the potential risks of the procedure to you and your unborn baby. These risks include rupture of your uterus after surgery (uterine rupture), fetal death, operative complications, early labor and potential failure to treat the spina bifida. Your doctor will also inform you about the possible benefits of the procedure and the long-term follow-up care your child will need.

During surgery

If the medical team determines surgery is appropriate for you and the unborn baby, surgery will generally be conducted 19 to 25 weeks into your pregnancy.

During surgery, you'll be given general anesthesia. A large team of specialists works together during the surgery to monitor you and your unborn baby.

Doctors then make an incision in your abdomen to expose your uterus. After opening the uterus, doctors move the unborn baby to allow the pediatric neurosurgeon to perform the procedure. The pediatric neurosurgeon closes the spina bifida opening. Then, doctors replace your amniotic fluid and close your uterus and abdomen. Surgery usually takes about two hours.

After surgery

After the surgery, you'll stay in or near the hospital for six to eight weeks. Doctors will monitor you closely for signs of complications, such as uterine rupture.

Doctors will conduct a planned cesarean delivery at about 37 weeks into the pregnancy. However, if your baby needs to be delivered sooner, doctors will perform a cesarean section at the needed time.

An integrated team of Mayo doctors trained in treating spina bifida cares for your child after his or her birth and helps manage his or her condition.

March 04, 2013